Wang Longde, Vice Minister, Ministry of Health, People's Republic of China
Trevor Neilson, Executive Director, Global Business Coalition on HIV/AIDS
Heather Burns, Senior Vice President, Booz Allen Hamilton

Mr. Neilson: GBC first started working in partnership with the Ministry of Health, under Minister Wang's leadership, about a year and-a-half ago, and at that time we looked at what multinational companies were doing and at what Chinese companies were doing to address AIDS in China and what we found was disturbing. And what we found was that companies were doing almost nothing to address AIDS in China.

We also found more excuses at every turn and the number one excuse was, "Gee, the government hasn't told us what to do" - which we think is an ironic excuse coming from industry. Industry doesn't usually wait for government to tell it what to do anywhere in the world. Industry certainly doesn't wait for the government of China to tell it how to manufacture products or to tell it how to sell its products. And it really was just an excuse.

But luckily, things have started to change since then, and a big part of that change is that the Chinese government, under the leadership of Minister Wang, has been very clear that there is a role for business to play in the fight against aids in China and that China's national AIDS strategy has been created considering the role of business - that there are very clear ways for businesses to engage.

So the event that Vishakha referred to in Beijing was really a turning point and was the beginning of a new era of corporate engagement in the fight against AIDS in China. When Vice Premier Wu Yi called on the multinational business community and the Chinese business community to become a part of the national AIDS strategy, it opened up a floodgate of new interest and enthusiasm. If fact, just a couple of weeks ago, we announced that 30 companies that are members of the GBC have come forward with new plans for action in China and these plans involve workplace prevention and education programs, involve the adoption of anti-stigma and anti-discrimination polices, which are essential to protect employees who want to come forward and say that they might be HIV-positive and they need to be tested. Companies are looking for ways to donate their products in the fight against AIDS in China and companies are looking at corporate philanthropy in China as well.

But perhaps most importantly, business leaders are starting to tell government leaders that they're concerned about AIDS and that they want government to act. The challenge in China is not in Beijing, it's not with the central government - the central government is one of the most active governments in the entire world in addressing this issue. It's in the provinces, it's farther out where people might not be as educated about the issue. And if a business leader who has significant investments in a province stands up and says to a provincial leader, "We want you to address AIDS", that has a very powerful effect and echoes the messages that are being sent by Beijing.

So GBC is going to be working in the next year to increase that kind of a response; we're looking at getting more companies to announce new AIDS policies in China; we're looking at other ways to push the message that Beijing is sending out into the provinces and to build more support at the local level. We all know - we learned this very painfully in the United States - it's one thing for the government in Washington or the government in Beijing to say something, it's a very different thing for it to be actually be implemented at the local level, and without that kind of implementation, we're not going to be able to provide the kind of support we need to people who are infected and need treatment or we're not going to be able to implement effective prevention and education efforts.

So GBC is really dedicated to this partnership; we're going to talk a lot more about it this morning, but it's my real pleasure to introduce the person who's really responsible for this partnership, Minister Wong Longde. Wang Longde is the Deputy General Secretary of the Communist Party of China Committee with the Ministry of Health. He is also the Vice Minister of the Ministry of Health. Mr. Wang graduated from the medical treatment department of (Lon jo ?) medical college in 1969, earned a master's degree from the Chinese academy of medicine sciences in 1980 and, perhaps most importantly, he is a New Yorker and lived and worked here, studied at Mount Si (nai) school of medicine. Unfortunately, we then lost him back to China and when he returned he won the honor of the excellent returned overseas Chinese scholars in public health program, a very prestigious program. And he was invited to be a part-time tutor for graduate students by the public health college of Peking Union Medical College.

With his research mainly focused on epidemiology, he contributed to 20 publications to domestic and overseas medical magazines from 1981 to 2002, while delivering a number of speeches and lectures on health that were wildly applauded among party school of CPC and government organs.

From my personal experience, Minster Wang has been the person who has made it okay for businesses to respond to AIDS in China and, in fact, he has made it an expectation. And he might not know this but he, for many multinational corporations and American corporations, is the person that they've looked to to instruct them how they should respond to this terrible problem.

So, with great pleasure, I'd like to introduce my friend, Minister Wang Longde.

Mr. Wang Longde (Vice Minister of Health of China) (interpreted from Chinese): Respected Mr. Neilson, gentlemen, good morning. It's a great pleasure for me to come back to New York and to see all the friends here. Today, we are gathered together to explore the impact of HIV/AIDS on China's economic and social development and to jointly study the strategies to combat AIDS and also to explore ways of cooperation in the fields of AIDS prevention and control. This signifies the attention and support given by international enterprises and the business sector to China's AIDS prevention and control. And also, I think it will promote the further cooperation and involvement of enterprises in China's AIDS control. This will have a lot of positive implications to curb the spread of AIDS in China.

The Chinese government pays a lot of attention to AIDS prevention and control; it has put AIDS as one of the top priorities in the government agenda in regards with the economic development, social stability, national security, as well as national prosperity.

The Chinese government has also made plans or programs of action for control of HIV/AIDS. It has implemented the "for free and one care" policy and has also implemented specific measures to control the AIDS spread.

One important element in the control of HIV/AIDS is to do some health education to fight against the stigma and discrimination against AIDS patients.

I really appreciate the fact that in May this year, the Global Forum, held in Beijing with the active coordination of GBC, [adopted] a declaration [that] was signed by 26 enterprises to promise to fight against discrimination against AIDS patients.

As many know, the Chinese President, Hu Jintao, and Premier Wen Jiabao went to hospitals, as well as down to the fields, to the provinces, to see the patients. This is another example of the government's attention to this issue.

Members of the GBC have not only had financial input in China's AIDS prevention and control, it also has implemented measures to fight against AIDS in workplaces. So this set a very good example for Chinese enterprises.

So I here welcome more and more GBC members or enterprises to come to China to support the course of HIV/AIDS prevention and control and conduct activities in that regard.

I hope that you can bring to China the international best practice of fulfilling the obligations of enterprises for society to China.

So, once again, thank you for the opportunity to present these remarks; I'm also available for any questions you might have.

Mr. Neilson: Thank you, Mr. Minister, for those remarks. I think that all of us take very seriously the challenge we have in China, but also the opportunity that we have in China and that by engaging new partners in the fight against AIDS in China, you're really doing something that no government in the world has done. No government has been as proactive in reaching out to new partners in the way that you have, and so we are so appreciative of your leadership and also the sophisticated way you're looking at addressing the issue; it's remarkable. And if countries like the United States had done the same thing in the 1980s, we might not be in the situation that we're in today. So it's great that the Chinese government is thinking about this in such a sophisticated manner.

I think that now, Minister Wang has agreed to have a brief question-and-answer session, and I have a list of initial questions that I wanted to ask you, if that's okay, and perhaps, if you're willing, others in the audience might have questions.

I think that the first question that I had had to do with the economic impact of this disease and what your thoughts are on why business should specifically be concerned with the disease and what it is that the government feels business should do to address it.

Mr. Wang Longde (interpreted from Chinese): I think enterprises are a very strong force in society. So the spread of AIDS is not only a concern or a problem of other sectors, but also a concern of the business sector. So if AIDS starts to spread in a certain factory or enterprise, then the productivity of that enterprise will go down. And also the morale of the staff will go down. And if AIDS spreads widely in society, it might also affect the economy and, in turn, affect enterprises. So I think that the business sector plays a very important role in AIDS prevention and control in society. And also many famous enterprises, as mentioned by Mr. Neilson, will play an important role and have an influence on the government because they are the economic pillar of society.

Mr. Neilson: That's a very good point. We have to hope, I guess, that they're willing to use that influence on a social issue in the same way that they should use it in a commercial issue.

Are there certain areas within China's national AIDS strategy that you think there are specific needs that companies should come forward to address?

Mr. Wang Longde (interpreted from Chinese): I think that in the first place, what enterprises can do is to have relevant regulations and rules in the workplace for the control of HIV/AIDS and also to conduct health education for their staff in relation to anti-stigma and discrimination and things like that. If all enterprises can do this then we'll see a very different picture from what we see today. On the other side, also, enterprises can do a lot for AIDS prevention and control for society. For example, there are some enterprises that have relations with the medical field - companies that produce equipment, test agents and things like that. They can also have close links with the AIDS field. For example the CD4 test equipment, the test agency and also antiretroviral drugs. This will have a very direct, positive impact on the AIDS-impacted persons or patients.

Mr. Neilson: You and I have both just been delegates to the United Nations General Assembly's special session of AIDS. And I'm just interested to get your perspective on the global situation. We were in a session yesterday together about resources in the fight against AIDS, money in the fight against AIDS. And I found the conversation very depressing and sad. I'm curious to get your reaction.

Mr. Wang Longde (interpreted from Chinese): I had the same feeling, actually. I realized that we all understand that in the international community, there has not been enough sense of the role that can be played by the business sector in AIDS prevention and control. So if governments do not have close collaboration with the business sector, with NGOs and civil society at large, it cannot do good work in terms of AIDS control. So we always have discussions and cooperation with the business sector, NGOs and civil society to have them play the role that governments can never play.

Mr. Neilson: How have you received funding from the Global Fund for AIDS, TB and malaria? How has that process been? Has that been an easy process to work with the Global Fund and do you see that as that best means of accessing international funding? I'm just interested to get your feelings on the Global Fund.

Mr. Wang Longde (interpreted from Chinese): I think the Global Fund has given very important support to China's AIDS control. They also have these problems in that the process of application to Fund is very complicated. And also it requires a lot of manpower and time. We want this process to be simple but meanwhile to maintain the efficiency and effectiveness of the process, while the support coming from the business sector, on the other hand, might be quicker and more active. One example is the collaboration with Merck, a member of the GBC. Within two months, we reached an agreement with Merck to have collaboration. So I think that the Global Fund process can be simplified. I think we have very good example of the government system to be on the right stand. [this interpretation not understood] I think we can improve efficiency from the government side also.

Mr. Neilson: Shifting topics a little bit, how do you think in China we should do a better job of getting business leaders to talk about sex and drugs? It's a difficult thing and I know that you have been very outspoken about these issues and you have no problem speaking about these issues and it seems that in fact Wen Jiabao and Hu Jintao and Wu Yi all speak very openly about this. But we haven't seen the same level of openness from business leaders and if you have advice for us, what would it be?

Mr. Wang Longde (interpreted from Chinese): Chinese people might be more conservative in talking about sex and AIDS. So when we talk with relevant sectors, including the business sector about sex and drugs, we do not directly mention these terms. We usually start by talking about infected persons and AIDS patients, and sex and drugs are only means of transmission of the disease. We see them as patients and the first thing we can do is to help them, support them. Because the disease is spread by sex and drugs and others, it can also have an impact on the normal population. It's an infectious disease; if we do not control the infection it will spread very quickly. In that case, if we do not control it effectively it will have an impact, not only on social stability but on the social economy and others. I think we can start with a change of perception.

Mr. Neilson: I was mentioning to the Minister that the other day, courtesy of one of our companies, APCO, I had lunch with Dr. Henry Kissinger, and Dr. Kissinger, as brilliant as he is, seemed to have a difficult time contemplating that a disease that is largely coming from certain segments of the population could have a major affect on an overall country, and it led me to think that maybe there is a generational issue here - that the younger generation will be more able to talk about sex, more able to talk about AIDS, and I think that that may be true in the US. Do you think that that's true in China?

Mr. Wang Longde (interpreted from Chinese): I think that in China it's the same. Mr. Kissinger is a very senior person also in America. In China we see the same change among young people similar to that in America.

Mr. Neilson: I guess that's a very hopeful scenario.

Well, my last question - then we'll go to Heather Burns, who I think will give us a presentation about our work in China, is what message to you have on behalf of the Premier and the Vice Premier and the President that China has for the rest of the world about China's response to this issue, and what should be happening on this issue globally?

Mr. Wang Longde (interpreted from Chinese): I think that the first thing we should say is that we could have more studies on this issue because we think so far there are a lot of things that we're not so clear about. For example, in terms of treatment of patients, we have the international standard of CD4 level below 200. We see that we can do nothing if the level is between 500 and 200. We see the CD4 level of patients go down and down and down and we see also the opportunistic infections. I think in that sense, Chinese traditional medicine can do something. It can at least maintain or slow down the decrease in the CD4 level.

Another issue is drug abuse. If I came to New York and then I went to Hunan province in China, most of the AIDS patients got their infection through drug use. The problem is how we can have the patients comply with the treatment scheme. So far this is a question that has not been totally solved internationally. These drug users actually do not usually comply with the treatment scheme. If they do not comply, it's very easy for drug resistance to emerge. On the one hand, we can try a methadone replacement program to maintain compliance. In that sense we need to do more studies and, with the help of the international community as well as the business sector, to further our work.

Mr. Neilson: I completely agree.

With that, maybe we should talk about one of the studies of this kind and have Heather Burns give us a presentation about the work that Booz Allen Hamilton has done with the government and with GBC.

Ms. Burns: It's a real pleasure and privilege for me to be here this morning to talk to such a very large group of individuals who are here to talk about an extremely important issue in a very, very important country.

My name is Heather Burns and I am a senior vice president at Booz Allen Hamilton, which is a management consulting firm. And I'm here to talk to you very briefly about an exercise that we participated in with GBC in Beijing in March.

The exercise was jointly sponsored, as I said, by GBC, but also by the China Ministry of Health, and it was called a "joint summit on business and AIDS in China" and was specifically designed to bring individuals together and forge business response to this very serious problem.

China is at a very, very critical crossroads. If the HIV/AIDS epidemic continues to grow, the economic impact on China could be very, very significant and in fact cause long term economic damage that would reverse the years of development that have been so impressive and pronounced in China.

We have developed economic as well as medical models that will allow a rough approximation of the impact on GDP and other economic measures. Unchecked, the economic impact on China could be extremely negative. However, with productive early interventions from all segments of China's society, the opportunity is very, very real to significantly reduce the impact.

In March, we held this strategic exercise in Beijing and the intent of this one-day session was to bring together government, business, civil NGO leaders to address the crisis and talk about its long term consequences. The exercise was the first of its kind in China and, as I said, was specifically designed to engage business response to HIV/AIDS. We had nearly 200 participants; they were a very broad cross-section of individuals from government, NGOs and business, and we divided the participants into ten groups representing a good cross-section within each group and we engaged them on what specifically they, with their organizations, could do to address this topic.

So what was different about this from some discussions that, as least I had participated in the past was that we broke off into small groups and looked at each other and engaged on specific things that we could commit to for our organizations right then, and then additional commitments we would be prepared to make at the summit that was to follow several months later.

And the group that I participated in - just to give you a flavor of the kind of representation we had - consisted of a medical director of a rural hospital who had a lot of day-to-day interaction with HIV/AIDS. We had two senior executives from global pharmaceutical companies; we had a senior representative from an NGO, among others. So this was a group that could get together as a cross-section and engage.

The participants identified a number of challenges - which I'm sure are not surprising to you - which stand in the way of significant progress in China. These range from resource shortages to cultural barriers. All of the participants very clearly acknowledged the leadership of the People's Republic of China in their efforts to prevent and control HIV/AIDS. They also, though, saw the need to extend the work of current programs and regulations and to participate in those extensions in a collaborative way.

Another very significant obstacle that has been raised several times this morning is the stigma associated with HIV/AIDS; this is a huge challenge to effective prevention treatment and support. An additional challenge in the delivery of HIV/AIDS response is the infrastructure in a country as large and diverse as China, with centers of urban population and tremendous population in very far away locations.

And finally, the public sector response, as Trevor said earlier, has been limited. We think it's a lack of understanding, a lack of awareness, and what we tried to engage with the business leaders there was it's a lack of commitment. It's not that hard to make commitments but it has to happen and it has to start with specific business leaders.

We tried to categorize all the input we received over the day and put them into four categories that we call "critical imperatives in China". First of all, continued government leadership is essential. No one is saying anything other than that the leadership has been very, very strong. But it needs to continue. Confidentiality and non-discrimination emerged as a very significant issue, as has been raised this morning. We need to focus very much on this in the workplace to reduce any kind of discrimination. As I understand it, significant progress has been made, even post-conference.

Next, we need private sector and government networks. One of the key findings was that the businesses themselves, as they came together, didn't realize how much collaboration could benefit each of them in working with networks and building up each other's program, and GBC obviously has a very important role to play in that.

And finally, education: I don't need to tell anybody here how vitally important it is - education within companies, education nationwide in China.

The teams came up with a very large list of responses - I will not go through these but they are very, very varied, they are creative and, as I said, there were commitments that individual companies and organizations were prepared to make.

As a result of the day, I think that what happened after the conference was just as significant as the conference itself, because a lot is happening as follow-up. Recommendations that were made were incorporated into an action plan that we helped GBC produce this has been disseminated and I think people are working on the various components. GBC very significantly announced that they would open and office in Beijing, working very closely with the ministry and the government in China.

And businesses demonstrated a very strong level of commitment to this issue, ranging from 26 companies signing up to explicit policies of non-discrimination, to a number of firms making commitments of things they could do that are things they are already doing in the course of their business to help this problem. Just to give you a couple of examples there, we had Ogilvy Public Relations agreeing to support an Asia Society symposium. We had Merck identifying and going into an agreement on HIV/AIDS prevention and control. We had a number of these - I think ten specific initiatives of companies doing what they already do, and extending that into this problem can have an enormous impact.

So we were very, very pleased to participate in this; it's been a pleasure to give you just a very, very short overview of that; if you're interested in hearing any more, I'm sure that GBC or Booz Allen can provide you with further information. Thank you very much.

Mr. Neilson: Thank you so much, Heather. I should also just say Booz Allen had their talks about the other companies making commitments to AIDS in China; well Booz Allen has made a multimillion dollar and multiyear commitment to support of GBC, which is something we appreciate so much. We couldn't be dealing - anything that we're doing, anywhere in the world, without Booz Allen. So thank you, Heather.

Now we have an opportunity to ask Minister Wang and also Heather some questions and let me just say that this is a great time to use their very valuable time preciously. So let's not have statements from people about the work that you're doing. If there's information that you want us to share with the Minister, we're happy to do so and you can submit that to us, but this is a chance to ask him questions; he's in the US for about a week; his time is very limited; he's graced us with some of it today. So do you have questions?

Unidentified speaker: You mentioned drug use as an issue in your remarks. Different governments have different policies and needle-exchange programs. We'd like to know what the government in China is thinking about needle-exchange programs for the drug-use population in China.

Mr. Wang Longde (interpreted from Chinese): In China, what we do is firstly through health education. Recently, we have done some pilots with collaboration with the Minister for Public Security. We use methadone replacement scheme to prevent these drug users to find the drugs. So we have agreement with the public security sector that if the drug users come to the replacement clinics, then they should not be sent to camp for education. Such clinics may go up to about a hundred this year. Problems such as in Hunan, where drug use is a major problem - we encourage them to increase the number of clinics as quickly as possible. So I think only through this can we prevent (unintelligible) drug users sharing needles so that we could start also ARV treatment to save their lives.

Unidentified speaker: (unintelligible) first question is, do you have any data as to the breakdown of AIDS victims - rural versus urban areas (unintelligible)?. The second question is, is GBC considering eventually getting into those areas such as such as migrant labor in the countryside to do projects there too, or are you (unintelligible) stick yourself just to industrial enterprise?

Mr. Neilson: Maybe I'll answer the last question first. GBC believes it is the responsibility of multinationals to address this issue within their entire support . . .